NPI | 1265222426 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO CP044358T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16827-24) |
Enumeration Date | 2025-05-10 |
Last Update Date | 2025-05-20 |