NPI | 1285614248 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT000598E) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 003149) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2008-05-19 |