NPI | 1083861751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT25930) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 11785) |
Enumeration Date | 2008-08-25 |
Last Update Date | 2023-10-05 |