NPI | 1164528899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT009781L) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT009781) |
225100000X Physical Therapist (Licence: PA DAPT000302) | |
Enumeration Date | 2006-09-16 |
Last Update Date | 2022-04-12 |