NPI | 1720035330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MD 20271) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: MD 20271) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2015-03-06 |