NPI | 1356717508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0014046) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0014046) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2024-04-11 |