NPI | 1093268492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37184) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL R200630943740) |
Enumeration Date | 2016-08-02 |
Last Update Date | 2022-07-18 |