NPI | 1457741316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT24232) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT24232) |
2251E1200X Physical Therapist, Ergonomics (Licence: CA PT24232) | |
Enumeration Date | 2015-01-30 |
Last Update Date | 2015-01-30 |