NPI | 1770145807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT296701) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT296701) |
Enumeration Date | 2019-06-28 |
Last Update Date | 2019-07-22 |