NPI | 1003180241 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61396) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034812) |
Enumeration Date | 2012-03-06 |
Last Update Date | 2018-06-04 |