NPI | 1700039542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172M00000X Mechanotherapist (Licence: WA MA60195852) |
Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OR 15618) |
Enumeration Date | 2008-10-24 |
Last Update Date | 2011-10-04 |