NPI | 1700838323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03532) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 1721) |
Enumeration Date | 2006-05-16 |
Last Update Date | 2019-02-18 |