NPI | 1225709215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT33089) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61142999) |
Enumeration Date | 2021-09-21 |
Last Update Date | 2023-07-12 |