NPI | 1598973745 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203973) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 28738) |
Enumeration Date | 2007-05-20 |
Last Update Date | 2008-07-28 |