| NPI | 1376227413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX CP031717T) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: GA PT016859) | |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2024-10-25 |