NPI | 1467558825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: RI PT02295) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 16094) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2011-10-03 |