NPI | 1033763966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2019-07-29 |
Last Update Date | 2019-11-21 |