NPI | 1255785507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28609) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 3960) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2016-04-22 |