NPI | 1336293133 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 23390) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 4296) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2013-01-10 |