NPI | 1063534410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 33384) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 5025) |
Enumeration Date | 2007-04-05 |
Last Update Date | 2007-07-08 |