NPI | 1417029083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9586) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1043339) |
Enumeration Date | 2006-11-15 |
Last Update Date | 2013-01-11 |