NPI | 1376307900 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC CP031198T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN CP027977T) |
225100000X Physical Therapist (Licence: NJ 40QA02191100) | |
Enumeration Date | 2024-02-13 |
Last Update Date | 2024-06-16 |