NPI | 1053450734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics (Licence: MD 19852) |
Additional Taxonomies | 2251G0304X Physical Therapist Geriatrics (Licence: VA 2305203397) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2007-07-08 |