NPI | 1407819709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT004496) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT7348) |
Enumeration Date | 2006-04-08 |
Last Update Date | 2007-07-08 |