NPI | 1922131010 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT00008622) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 6665) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2007-07-08 |