NPI | 1053657288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT20482) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT007594) |
Enumeration Date | 2012-12-16 |
Last Update Date | 2012-12-16 |