NPI | 1275098089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10499) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P18538) |
Enumeration Date | 2019-02-06 |
Last Update Date | 2021-01-13 |