NPI | 1851593362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 4304) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
Enumeration Date | 2007-06-05 |
Last Update Date | 2015-05-13 |