NPI | 1093398315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 302724) |
225100000X Physical Therapist (Licence: PA PT029634) | |
Enumeration Date | 2021-05-04 |
Last Update Date | 2024-06-04 |