| NPI | 1275849531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT29373) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NC 12761) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2014-06-27 |