NPI | 1891732467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 5576) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 5576) |
2251G0304X Physical Therapist, Geriatrics (Licence: AZ 5576) | |
2251H1200X Physical Therapist, Hand (Licence: AZ 5576) | |
2251P0200X Physical Therapist, Pediatrics (Licence: AZ 5576) | |
2251S0007X Physical Therapist, Sports (Licence: AZ 5576) | |
Enumeration Date | 2006-06-01 |
Last Update Date | 2023-01-17 |