NPI | 1225406226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT30355) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL 30355) |
Enumeration Date | 2015-09-08 |
Last Update Date | 2024-05-30 |