NPI | 1447234943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00004086) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01630) |
Enumeration Date | 2005-11-30 |
Last Update Date | 2011-05-04 |