| NPI | 1841250198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT2370) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT2660) |
| 225200000X Physical Therapy Assistant (Licence: AR PTA2715) | |
| 224Z00000X Occupational Therapy Assistant (Licence: AR OTA936) | |
| 225X00000X Occupational Therapist (Licence: AR OTR825) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-07-31 |