NPI | 1508011826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1128841) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1128841) |
Enumeration Date | 2008-12-01 |
Last Update Date | 2008-12-01 |