NPI | 1346091980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 6589) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 305801) |
Enumeration Date | 2024-04-01 |
Last Update Date | 2025-03-24 |