NPI | 1255592291 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 26146) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT019301) |
Enumeration Date | 2008-06-23 |
Last Update Date | 2024-01-25 |