NPI | 1225537228 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 5867) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OK CP004023T) |
225100000X Physical Therapist (Licence: TX 1301339) | |
Enumeration Date | 2018-02-05 |
Last Update Date | 2022-07-28 |