NPI | 1104283282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003440) |
Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: IN 05014405A) |
2251X0800X Physical Therapist, Orthopedic (Licence: IN 05014405A) | |
Enumeration Date | 2016-01-21 |
Last Update Date | 2023-08-30 |