NPI | 1174201099 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: IL 070.026600) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 304632) |
Enumeration Date | 2023-07-10 |
Last Update Date | 2024-05-01 |