NPI | 1659466324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5159) |
Additional Taxonomies | 174400000X Specialist (Licence: AZ 5159) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2020-07-08 |