NPI | 1871921080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 40893) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034791-1) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2016-06-23 |