NPI | 1730164690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 0334) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00009718) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2012-11-13 |