NPI | 1578749891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT29163) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009003) |
Enumeration Date | 2008-01-16 |
Last Update Date | 2016-09-14 |