NPI | 1972969988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13065) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11987) |
225100000X Physical Therapist (Licence: MN 10133) | |
Enumeration Date | 2016-01-06 |
Last Update Date | 2016-05-08 |