NPI | 1891015749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: FL PT25109) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031467) |
225100000X Physical Therapist (Licence: FL PT 25109) | |
Enumeration Date | 2010-06-02 |
Last Update Date | 2024-04-29 |