NPI | 1164460341 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0001620) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT015446) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2010-06-14 |