NPI | 1861548281 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: GA PT 005228) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT005228) |
Enumeration Date | 2007-01-26 |
Last Update Date | 2016-03-01 |