NPI | 1033541560 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011075) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT011075) |
Enumeration Date | 2013-08-07 |
Last Update Date | 2018-06-27 |