NPI | 1407973258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011814) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT27795) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2014-06-20 |