NPI | 1881775450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0003333) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 3333) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2018-01-18 |