NPI | 1033270681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT026501) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 024410) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2018-04-03 |