NPI | 1013326180 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29569) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT29569) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2022-10-19 |