NPI | 1114175098 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501001186) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MI 5201003272) |
Enumeration Date | 2008-09-03 |
Last Update Date | 2008-09-03 |