NPI | 1659769388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024227) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000437) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT006059) | |
225100000X Physical Therapist (Licence: WV PT003438) | |
Enumeration Date | 2015-01-05 |
Last Update Date | 2015-02-10 |