NPI | 1346395712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT576) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ID OT129) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2013-04-19 |