NPI | 1386219293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT019258) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37162) |
Enumeration Date | 2021-05-24 |
Last Update Date | 2022-04-04 |