NPI | 1255676003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3049) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 3049) |
Enumeration Date | 2012-12-05 |
Last Update Date | 2013-12-06 |