NPI | 1396238317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 60865283) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 15655) |
Enumeration Date | 2018-06-13 |
Last Update Date | 2018-07-03 |