NPI | 1215367826 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501009658) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 014646) |
Enumeration Date | 2013-11-18 |
Last Update Date | 2013-11-18 |