NPI | 1326613290 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12060111-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 4528) |
Enumeration Date | 2021-05-24 |
Last Update Date | 2024-09-17 |