NPI | 1275869273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 11178) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 36115) |
Enumeration Date | 2009-10-26 |
Last Update Date | 2012-04-06 |