NPI | 1194811273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT26304) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 5885) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2016-10-14 |