NPI | 1487930368 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4013) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 8850) |
Enumeration Date | 2011-10-24 |
Last Update Date | 2011-10-27 |