NPI | 1497070841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501015145) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501015145) |
Enumeration Date | 2010-03-29 |
Last Update Date | 2014-04-09 |