NPI | 1265888929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH7977) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 11470) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2021-09-29 |