NPI | 1205205853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 4714) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 14275) |
Enumeration Date | 2015-09-24 |
Last Update Date | 2023-10-20 |