NPI | 1376564740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 8060) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT0019085) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2011-10-20 |