NPI | 1336567023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 41176) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 037122) |
Enumeration Date | 2014-03-31 |
Last Update Date | 2014-03-31 |