NPI | 1235493644 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1274856) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070014894) |
Enumeration Date | 2012-06-29 |
Last Update Date | 2018-11-07 |