NPI | 1225540594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 294089) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0014976) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2018-11-27 |