NPI | 1225333461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA61559) |
Enumeration Date | 2011-01-19 |
Last Update Date | 2022-10-09 |