NPI | 1316171069 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004811) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070-017293) |
225100000X Physical Therapist (Licence: NE 3433) | |
Enumeration Date | 2009-05-11 |
Last Update Date | 2015-04-29 |