NPI | 1336887280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 13707) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 14.013487-TEMP) |
Enumeration Date | 2022-05-21 |
Last Update Date | 2022-09-02 |