NPI | 1013609304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP042936T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0019109) |
Enumeration Date | 2023-05-24 |
Last Update Date | 2025-04-04 |