NPI | 1174739866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1171468) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2015-04-20 |