NPI | 1366990756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 292010) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 292010) |
Enumeration Date | 2016-09-14 |
Last Update Date | 2023-04-27 |