NPI | 1184007585 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 62712) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 100355) |
225100000X Physical Therapist (Licence: CO 0013276) | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2024-04-16 |