NPI | 1487984506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251G0304X Physical Therapist Geriatrics (Licence: FL PT 20550) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 20550) |
Enumeration Date | 2010-01-12 |
Last Update Date | 2010-01-27 |