NPI | 1184655458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
Additional Taxonomies | 225100000X Physical Therapist |
2251X0800X Physical Therapist, Orthopedic | |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2010-03-22 |