NPI | 1770830903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12000) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 34735) |
Enumeration Date | 2012-08-07 |
Last Update Date | 2024-06-13 |