NPI | 1144230525 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OK PT1863) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1-4404-8) |
Enumeration Date | 2006-08-09 |
Last Update Date | 2007-07-08 |