| NPI | 1982114419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0019X Occupational Therapist Physical Rehabilitation (Licence: TX 120114) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042711) |
| 225100000X Physical Therapist (Licence: FL PT33183) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: TX 1319694) | |
| 225X00000X Occupational Therapist (Licence: FL OT18004) | |
| 225X00000X Occupational Therapist (Licence: NY 022046) | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2021-10-29 |