NPI | 1861733305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1217131) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 27283) |
Enumeration Date | 2013-03-07 |
Last Update Date | 2013-03-07 |