NPI | 1033318183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CO PTL9983) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT23467) |
Enumeration Date | 2007-07-17 |
Last Update Date | 2008-06-06 |