NPI | 1174183354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37197) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT004139) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2023-03-23 |