NPI | 1164767323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT019049) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070019600) |
Enumeration Date | 2012-11-29 |
Last Update Date | 2021-03-31 |