NPI | 1679731210 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011059) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MI 5501011059) |
Enumeration Date | 2008-05-30 |
Last Update Date | 2014-03-18 |