NPI | 1558393140 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 6849) |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: NC 6849) |
225100000X Physical Therapist (Licence: FL pt26341) | |
Enumeration Date | 2006-07-06 |
Last Update Date | 2013-03-04 |