NPI | 1629113352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2002014672) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 1103197) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2007-07-08 |