NPI | 1649510520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1224026) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60330419) |
Enumeration Date | 2013-02-28 |
Last Update Date | 2013-11-20 |