NPI | 1255693750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-04455) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2012031786) |
Enumeration Date | 2012-06-11 |
Last Update Date | 2012-11-09 |