NPI | 1467699553 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 37754) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 24529) |
Enumeration Date | 2009-01-12 |
Last Update Date | 2022-02-11 |