NPI | 1295992006 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT 35755) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029361-1) |
225100000X Physical Therapist (Licence: TN 8295) | |
Enumeration Date | 2008-05-20 |
Last Update Date | 2023-01-17 |