NPI | 1053796425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005122) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 40930) |
Enumeration Date | 2015-07-27 |
Last Update Date | 2015-07-27 |