NPI | 1346478914 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 8449268-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 2233) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2020-01-28 |