NPI | 1568618254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV PT 2240) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2487) |
Enumeration Date | 2008-08-13 |
Last Update Date | 2009-02-11 |