NPI | 1164531133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 1310) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 3285) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-07-08 |