NPI | 1851604896 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT42321) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA PT42321) |
225100000X Physical Therapist (Licence: WI 11543-24) | |
Enumeration Date | 2010-07-20 |
Last Update Date | 2017-10-12 |