NPI | 1144626474 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11235729-2401) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: UT 11235729-2401) |
Enumeration Date | 2014-11-13 |
Last Update Date | 2022-12-06 |