NPI | 1003031899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: CA PT27871) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT27871) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2007-07-08 |