NPI | 1932401759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: FL 25858) |
Enumeration Date | 2010-11-30 |
Last Update Date | 2020-02-13 |