NPI | 1184137994 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215835) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041752) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2023-06-11 |