NPI | 1770831414 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4177) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293243) |
Enumeration Date | 2012-08-28 |
Last Update Date | 2018-06-15 |