NPI | 1013334416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ME PT4089) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA PT4089) |
Enumeration Date | 2014-03-24 |
Last Update Date | 2014-03-24 |