| NPI | 1447680889 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023225) |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2018-03-17 |