NPI | 1811257900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13233) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 38972) |
Enumeration Date | 2012-05-22 |
Last Update Date | 2020-11-17 |