NPI | 1306061403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P11076) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 7789) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2023-11-08 |