NPI | 1275178527 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016682) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05013342A) |
Enumeration Date | 2019-11-11 |
Last Update Date | 2019-11-11 |