NPI | 1215459342 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36652) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 028470) |
Enumeration Date | 2009-01-05 |
Last Update Date | 2019-05-28 |