NPI | 1619990546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT1365) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00007703) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2008-01-02 |