NPI | 1346958113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT61529887) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 64744) |
Enumeration Date | 2022-11-10 |
Last Update Date | 2024-07-01 |