NPI | 1225248891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD A2614) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD A2614) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2007-07-08 |