NPI | 1184042129 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3511) |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: ID PT-3511) |
Enumeration Date | 2014-04-06 |
Last Update Date | 2014-09-22 |