| NPI | 1841390267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC CP038511T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT016389) |
| 225100000X Physical Therapist (Licence: GA PT016886) | |
| 225100000X Physical Therapist (Licence: AL PTH10756) | |
| 225100000X Physical Therapist (Licence: PA PT032698) | |
| 225100000X Physical Therapist (Licence: TN 15396) | |
| 225100000X Physical Therapist (Licence: SC CP036847T) | |
| 225100000X Physical Therapist (Licence: OR 65130) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-12-27 |