NPI | 1083732465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207222) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 012806L) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2023-11-27 |