NPI | 1265535587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-014659) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MA PTL22686) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2025-02-24 |