NPI | 1952342602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: CA PT26095) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT26095) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2011-03-01 |