NPI | 1013214410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT010189) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT018822) |
Enumeration Date | 2011-02-21 |
Last Update Date | 2011-10-11 |