NPI | 1275817546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 26924) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA PT26924) |
Enumeration Date | 2011-10-05 |
Last Update Date | 2020-03-27 |