| NPI | 1851495030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1901) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25955) |
| 225100000X Physical Therapist (Licence: OR 61680) | |
| 225100000X Physical Therapist (Licence: ND 1694) | |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-13927) | |
| 225100000X Physical Therapist (Licence: ME PT6071) | |
| 225100000X Physical Therapist (Licence: KS 11-06915) | |
| 225100000X Physical Therapist (Licence: MN 10529) | |
| 225100000X Physical Therapist (Licence: AL PTH10586) | |
| 225100000X Physical Therapist (Licence: NV 4722) | |
| 225100000X Physical Therapist (Licence: NM PT6056) | |
| 225100000X Physical Therapist (Licence: MI 5501301784) | |
| 225100000X Physical Therapist (Licence: CA 301958) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2022-06-08 |