NPI | 1578994398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022602) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014513) |
Enumeration Date | 2013-12-04 |
Last Update Date | 2013-12-04 |