NPI | 1689881054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 1147) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009588) |
225100000X Physical Therapist (Licence: AZ 6738) | |
Enumeration Date | 2007-05-16 |
Last Update Date | 2008-10-29 |