NPI | 1386817542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT24674) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009292) |
225100000X Physical Therapist (Licence: NY 019287) | |
Enumeration Date | 2008-04-09 |
Last Update Date | 2012-05-11 |