| NPI | 1932733870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1264646) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37347) |
| 225100000X Physical Therapist (Licence: CA 301140) | |
| 225100000X Physical Therapist (Licence: NY 048380) | |
| 225100000X Physical Therapist (Licence: CT 13437) | |
| 225100000X Physical Therapist (Licence: NM PT5812) | |
| 225100000X Physical Therapist (Licence: IL 070.025844) | |
| 225100000X Physical Therapist (Licence: NV A-1357) | |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2023-05-03 |