NPI | 1396285904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 5994) |
Enumeration Date | 2017-03-01 |
Last Update Date | 2024-04-18 |