NPI | 1194144105 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 10088) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL 15590) |
225X00000X Occupational Therapist (Licence: TN 4979) | |
Enumeration Date | 2014-04-08 |
Last Update Date | 2014-05-29 |