NPI | 1063088052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37001) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT029256) |
Enumeration Date | 2021-06-01 |
Last Update Date | 2024-08-20 |