| NPI | 1871065946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-27276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT.PT.61301374) |
| 225100000X Physical Therapist (Licence: HI PT-5554) | |
| 225100000X Physical Therapist (Licence: NM PT22022) | |
| 225100000X Physical Therapist (Licence: OR 64478) | |
| 225100000X Physical Therapist (Licence: AZ LPT-30077) | |
| 225100000X Physical Therapist (Licence: UT 11079648-2401) | |
| 225100000X Physical Therapist (Licence: CA PT295364) | |
| Enumeration Date | 2018-12-29 |
| Last Update Date | 2023-10-13 |