NPI | 1952455685 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT003354) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: GA PT003354) |
2251X0800X Physical Therapist, Orthopedic (Licence: GA PT003354) | |
Enumeration Date | 2007-01-22 |
Last Update Date | 2016-12-06 |