NPI | 1720198435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT25868) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2006-08-30 |
Last Update Date | 2010-09-14 |