NPI | 1538394283 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
Enumeration Date | 2009-05-26 |
Last Update Date | 2009-07-13 |