NPI | 1093839631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22732) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: FL PT22732) |
2251X0800X Physical Therapist, Orthopedic (Licence: FL PT22732) | |
Enumeration Date | 2007-03-19 |
Last Update Date | 2013-12-06 |