NPI | 1124003223 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251H1200X Physical Therapist, Hand (Licence: WA PT00007743) |
Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: OR 3039) |
Enumeration Date | 2005-12-12 |
Last Update Date | 2009-10-23 |