NPI | 1700869484 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2492) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00007395) |
Enumeration Date | 2005-11-28 |
Last Update Date | 2015-12-14 |