NPI | 1508080227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 14283) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT 14283) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2007-07-08 |