NPI | 1225683808 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT4666) |
Enumeration Date | 2019-08-09 |
Last Update Date | 2023-10-18 |