NPI | 1629264999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 00010759) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 006725) |
225100000X Physical Therapist (Licence: CA 33473) | |
225X00000X Occupational Therapist (Licence: WA 00010759) | |
Enumeration Date | 2007-09-20 |
Last Update Date | 2023-10-13 |