| NPI | 1962661116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT14616) |
| Additional Taxonomies | 2251C2600X (Licence: FL PT14616) |
| 2251E1200X Physical Therapist, Ergonomics (Licence: FL PT14616) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: PT14616) | |
| 2251N0400X Physical Therapist, Neurology (Licence: FL PT14616) | |
| 2251S0007X Physical Therapist, Sports (Licence: FL PT14616) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT14616) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2010-05-19 |