NPI | 1356779268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0001811) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT016048) |
Enumeration Date | 2013-10-31 |
Last Update Date | 2023-09-06 |