NPI | 1114238086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1197830) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 3108858) |
Enumeration Date | 2010-06-25 |
Last Update Date | 2018-03-17 |