| NPI | 1770996472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 9053454-2401) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: UT 905354-2401) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: UT 905354-2401) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: UT 905354-2401) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2024-05-02 |