NPI | 1144423302 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT13997) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA PT13997) |
2251X0800X Physical Therapist, Orthopedic (Licence: CA PT13997) | |
Enumeration Date | 2007-06-06 |
Last Update Date | 2014-10-28 |