NPI | 1376580928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH6681) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 1393) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2018-02-21 |