NPI | 1033422902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8765) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305206565) |
Enumeration Date | 2010-07-21 |
Last Update Date | 2018-03-21 |