NPI | 1790968337 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60514) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 33294) |
225100000X Physical Therapist (Licence: WA PT60751940) | |
Enumeration Date | 2007-12-05 |
Last Update Date | 2024-05-21 |