NPI | 1982118741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 13153) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13153) |
Enumeration Date | 2017-11-30 |
Last Update Date | 2017-11-30 |