NPI | 1053300277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 001533) |
Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: KY 10011030054) |
Enumeration Date | 2005-10-20 |
Last Update Date | 2017-02-27 |