NPI | 1346286002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 6600) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 8463) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2007-10-30 |