NPI | 1215439070 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251N0400X Physical Therapist, Neurology (Licence: MI 5501001596) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501001596) |
Enumeration Date | 2018-03-07 |
Last Update Date | 2018-03-07 |