NPI | 1235534827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12343) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 41800) |
Enumeration Date | 2014-10-26 |
Last Update Date | 2017-05-09 |