NPI | 1316973266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 6286) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 6276-024) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2013-03-28 |