NPI | 1346670486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16958) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208222) |
Enumeration Date | 2013-11-26 |
Last Update Date | 2017-04-11 |