NPI | 1053576884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT24170) |
Enumeration Date | 2008-07-21 |
Last Update Date | 2024-06-06 |