NPI | 1861552747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60108164) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT01915) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2010-03-10 |