NPI | 1518255546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60315311) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9048) |
Enumeration Date | 2011-07-12 |
Last Update Date | 2024-04-01 |