NPI | 1265558373 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT016630) |
Additional Taxonomies | 171100000X Acupuncturist (Licence: PA AK000999) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2015-04-20 |