NPI | 1063519726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171100000X Acupuncturist (Licence: CA AC 13995) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ QA009772) |
225100000X Physical Therapist (Licence: PA PT016150) | |
225100000X Physical Therapist (Licence: CA 33779) | |
Enumeration Date | 2006-09-17 |
Last Update Date | 2015-07-07 |