NPI | 1023183464 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT21545) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT21545) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2024-01-27 |