NPI | 1235745514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 298683) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO CPO14329T) |
225100000X Physical Therapist (Licence: MD 28405) | |
Enumeration Date | 2020-09-22 |
Last Update Date | 2024-09-30 |