NPI | 1043677610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 3278) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 10658719-2401) |
225100000X Physical Therapist (Licence: ID PT-4299) | |
Enumeration Date | 2016-01-26 |
Last Update Date | 2020-03-24 |