NPI | 1598122657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 96403242401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 96403248016) |
Enumeration Date | 2016-01-20 |
Last Update Date | 2016-02-10 |