NPI | 1790889343 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251C2600X (Licence: FL PT15056) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0014581) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2017-02-15 |