NPI | 1699709154 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 828) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6179) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2010-03-25 |