NPI | 1497103949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 9802890-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT - 4660) |
Enumeration Date | 2016-05-25 |
Last Update Date | 2016-05-25 |