NPI | 1922209477 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 153) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 356) |
Enumeration Date | 2007-05-31 |
Last Update Date | 2007-07-08 |