NPI | 1306222799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 115430) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1262136) |
Enumeration Date | 2015-08-07 |
Last Update Date | 2022-11-01 |