NPI | 1750388922 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT005992) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT17063) |
Enumeration Date | 2005-07-04 |
Last Update Date | 2007-07-08 |