NPI | 1649428913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: FL PT9195) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT9115) |
Enumeration Date | 2008-08-28 |
Last Update Date | 2008-08-28 |