NPI | 1487786810 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 21437) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MD 21437) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2020-06-06 |