NPI | 1861654873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4448) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 4448) |
Enumeration Date | 2008-06-30 |
Last Update Date | 2015-11-05 |