NPI | 1386032365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 42525) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25281) |
Enumeration Date | 2014-12-29 |
Last Update Date | 2021-04-29 |