NPI | 1013184688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NC 13298) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 018490-1) |
Enumeration Date | 2008-05-13 |
Last Update Date | 2011-08-18 |