NPI | 1336902980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020146) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 61525747) |
Enumeration Date | 2024-02-05 |
Last Update Date | 2024-09-23 |