NPI | 1508074816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CA PT32333) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT PT32333) |
225100000X Physical Therapist (Licence: CA PT32333) | |
Enumeration Date | 2007-05-18 |
Last Update Date | 2010-01-25 |