NPI | 1093223893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT33153) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14064-24) |
Enumeration Date | 2018-01-15 |
Last Update Date | 2023-03-20 |