NPI | 1184872616 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2009000182) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8175) |
Enumeration Date | 2008-09-09 |
Last Update Date | 2009-03-16 |