NPI | 1881709046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3925) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT00005465) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2007-07-08 |