NPI | 1013187095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL 24086) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 12648) |
Enumeration Date | 2008-03-06 |
Last Update Date | 2008-07-08 |