NPI | 1750713434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005283) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12390-24) |
Enumeration Date | 2013-08-05 |
Last Update Date | 2014-05-07 |