NPI | 1245433838 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 28043) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6497) |
Enumeration Date | 2007-06-09 |
Last Update Date | 2013-05-30 |