NPI | 1295066454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: GA 010993) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032095) |
225100000X Physical Therapist (Licence: GA 010551) | |
Enumeration Date | 2010-01-27 |
Last Update Date | 2021-01-20 |