NPI | 1124395819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics |
Additional Taxonomies | 2251N0400X Physical Therapist Neurology |
2251X0800X Physical Therapist Orthopedic | |
Enumeration Date | 2011-11-22 |
Last Update Date | 2024-06-04 |