NPI | 1114418167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11774299-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 5074) |
Enumeration Date | 2018-05-25 |
Last Update Date | 2024-09-19 |