NPI | 1053623447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 3695) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19132) |
Enumeration Date | 2010-07-14 |
Last Update Date | 2016-08-25 |