NPI | 1548266943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1616) |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NE 1616) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2007-07-08 |