NPI | 1093231656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 25348) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT32651) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2024-06-12 |