NPI | 1417268111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002626) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020577) |
Enumeration Date | 2010-06-28 |
Last Update Date | 2014-07-09 |