NPI | 1013307768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: KY 008998) |
225100000X Physical Therapist (Licence: KY 008998) | |
2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: WY 1564) | |
Enumeration Date | 2015-02-03 |
Last Update Date | 2024-01-03 |