NPI | 1477662096 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: LA MD202040) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2006-08-29 |
Last Update Date | 2011-05-26 |