NPI | 1386998029 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2013005479) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH 014049) |
Enumeration Date | 2012-11-02 |
Last Update Date | 2013-05-08 |