NPI | 1033567862 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12567678-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 4473) |
225100000X Physical Therapist (Licence: ID 4627) | |
Enumeration Date | 2016-06-02 |
Last Update Date | 2022-01-25 |