NPI | 1114678232 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT210002176) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 28823) |
Enumeration Date | 2022-01-11 |
Last Update Date | 2023-09-16 |