NPI | 1780792796 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 10069) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4062) |
Enumeration Date | 2006-08-29 |
Last Update Date | 2021-12-22 |