NPI | 1275998932 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT291509) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209986) |
225100000X Physical Therapist (Licence: IL 070022267) | |
Enumeration Date | 2015-12-23 |
Last Update Date | 2025-07-10 |