NPI | 1366832271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 4190) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 3002) |
Enumeration Date | 2015-01-30 |
Last Update Date | 2016-07-19 |