NPI | 1063707016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 08065) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05010547A) |
Enumeration Date | 2011-06-17 |
Last Update Date | 2014-08-19 |