NPI | 1710911250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CO 8909) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2022-09-28 |