NPI | 1932103447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 5239) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 6999) |
Enumeration Date | 2005-06-13 |
Last Update Date | 2019-06-11 |