NPI | 1477544062 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT002226L) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1135168) |
Enumeration Date | 2005-11-02 |
Last Update Date | 2009-06-30 |