NPI | 1033169149 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-008156) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 02842) |
Enumeration Date | 2006-05-11 |
Last Update Date | 2012-04-12 |