NPI | 1033742689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: TX 1269553) |
Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: TX 1269553) |
Enumeration Date | 2020-02-21 |
Last Update Date | 2020-08-03 |