NPI | 1083097125 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9953) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12118-24) |
225100000X Physical Therapist (Licence: IL 070.019559) | |
Enumeration Date | 2015-07-07 |
Last Update Date | 2015-07-09 |