NPI | 1346045945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: KY 009059) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: FL 40883) |
2251X0800X Physical Therapist, Orthopedic (Licence: TX 1380498) | |
Enumeration Date | 2025-02-17 |
Last Update Date | 2025-02-17 |