| NPI | 1881966976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 38743) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-07214) |
| 225100000X Physical Therapist (Licence: CA 303921) | |
| 225100000X Physical Therapist (Licence: NM 22041) | |
| 225100000X Physical Therapist (Licence: HI 4716) | |
| 225100000X Physical Therapist (Licence: OH PT020761) | |
| 225100000X Physical Therapist (Licence: NV 5078) | |
| 225100000X Physical Therapist (Licence: IL 070.027214) | |
| 225100000X Physical Therapist (Licence: TX 1371959) | |
| 225100000X Physical Therapist (Licence: PA 031151) | |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2024-09-30 |