NPI | 1083109755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60989646) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT294922) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2019-09-26 |