NPI | 1114328788 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003078) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1241541) |
Enumeration Date | 2014-09-14 |
Last Update Date | 2021-02-26 |