NPI | 1275769218 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-5779) |
Additional Taxonomies | 172M00000X Mechanotherapist (Licence: WA MA 60074750) |
Enumeration Date | 2009-06-04 |
Last Update Date | 2018-05-31 |