NPI | 1174551469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 11098) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 23259) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2007-12-06 |