NPI | 1841620374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05011308A) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36002205A) |
Enumeration Date | 2013-11-19 |
Last Update Date | 2013-11-21 |