NPI | 1700972874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
2251S0007X Physical Therapist, Sports | |
2251X0800X Physical Therapist, Orthopedic | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2008-07-24 |