NPI | 1275983983 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 299094) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 12224) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2023-12-05 |