NPI | 1518122100 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 7833639-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 07391) |
Enumeration Date | 2008-07-23 |
Last Update Date | 2011-04-01 |