NPI | 1336452820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206577) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2010-07-26 |
Last Update Date | 2025-06-27 |