NPI | 1609130905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN PT10659) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010634) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2016-11-10 |