NPI | 1194960591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 3492) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1057578) |
Enumeration Date | 2008-12-14 |
Last Update Date | 2008-12-14 |