NPI | 1386954931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH CP032980T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023971) |
225100000X Physical Therapist (Licence: VA 2305208891) | |
225100000X Physical Therapist (Licence: NY 038226) | |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 002545) | |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT005488) | |
Enumeration Date | 2010-10-18 |
Last Update Date | 2024-08-09 |