| NPI | 1811446792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-5695-0) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT291565) |
| 225100000X Physical Therapist (Licence: WY PT-2261) | |
| 225100000X Physical Therapist (Licence: NM PT22028) | |
| 225100000X Physical Therapist (Licence: ID PT-8519) | |
| 225100000X Physical Therapist (Licence: FL TPPT251) | |
| 225100000X Physical Therapist (Licence: WI 16177-24) | |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2023-10-24 |