| NPI | 1417119439 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 1909) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital (Licence: HI 1909) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2008-06-30 |