NPI | 1205204336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1265940) |
Enumeration Date | 2015-09-06 |
Last Update Date | 2015-09-25 |