NPI | 1093088650 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 11598) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004894) |
Enumeration Date | 2012-02-13 |
Last Update Date | 2012-02-13 |