NPI | 1437486917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1215176) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 113972) |
Enumeration Date | 2009-11-04 |
Last Update Date | 2012-03-29 |