NPI | 1336549229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12948-24) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8887515-2401) |
Enumeration Date | 2014-08-27 |
Last Update Date | 2016-12-07 |