NPI | 1811149206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0002397) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22700) |
Enumeration Date | 2008-10-16 |
Last Update Date | 2013-02-07 |