| NPI | 1982646964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00646600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0004848) |
| 225100000X Physical Therapist (Licence: WY PT-0495) | |
| 225100000X Physical Therapist (Licence: MA PTL9444) | |
| 225100000X Physical Therapist (Licence: PA PT002970E) | |
| 225100000X Physical Therapist (Licence: UT 274690-2401) | |
| 225100000X Physical Therapist (Licence: AZ LPT-002845) | |
| 225100000X Physical Therapist (Licence: CT 5183) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2024-01-11 |