NPI | 1154646651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1195447) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 1433) |
Enumeration Date | 2010-03-29 |
Last Update Date | 2011-12-15 |