NPI | 1396281705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT 1148) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO PT 104934) |
Enumeration Date | 2017-01-09 |
Last Update Date | 2017-01-09 |