NPI | 1124138508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00007033) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 7033) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2018-03-06 |