NPI | 1881066819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT297910) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11898) |
Enumeration Date | 2015-10-29 |
Last Update Date | 2020-01-10 |