| NPI | 1801970082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501006896) |
| Additional Taxonomies | 2251E1200X Physical Therapist Ergonomics (Licence: MI 5501006896) |
| 2251G0304X Physical Therapist Geriatrics (Licence: MI 5501006896) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: MI 5501006896) | |
| 2251S0007X Physical Therapist Sports (Licence: MI 5501006896) | |
| 2251H1200X Physical Therapist Hand (Licence: MI 5501006896) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2017-08-15 |