NPI | 1336135284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 21182) |
2251X0800X Physical Therapist, Orthopedic | |
Enumeration Date | 2005-09-26 |
Last Update Date | 2024-09-28 |