NPI | 1124495148 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13296) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070021746) |
Enumeration Date | 2015-08-25 |
Last Update Date | 2024-07-23 |