NPI | 1992715460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 1242) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: NM 4329) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2007-07-08 |