NPI | 1013094473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 2670) |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2025-09-11 |