NPI | 1689153710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: IA 087785) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2018-08-23 |