NPI | 1598757841 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH5787) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT2390) |
Enumeration Date | 2005-08-22 |
Last Update Date | 2013-01-02 |