NPI | 1174602031 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT23292) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 008374) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2024-11-15 |