NPI | 1174113955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24914) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO CP044517T) |
Enumeration Date | 2021-01-25 |
Last Update Date | 2025-09-29 |