NPI | 1205617321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT016884) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR CP025623T) |
Enumeration Date | 2023-10-13 |
Last Update Date | 2023-10-13 |