NPI | 1801921598 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 5728) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT018125) |
225100000X Physical Therapist (Licence: TX 1169143) | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2009-03-09 |