NPI | 1174844039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 9220) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT14281) |
Enumeration Date | 2010-06-15 |
Last Update Date | 2018-03-15 |