NPI | 1023018827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-02336) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2001018689) |
Enumeration Date | 2005-07-22 |
Last Update Date | 2008-01-31 |