NPI | 1356657134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ PT9578) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT37054) |
Enumeration Date | 2010-08-31 |
Last Update Date | 2012-07-23 |