NPI | 1396421954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
Additional Taxonomies | 225100000X Physical Therapist |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2023-06-27 |
Last Update Date | 2023-06-27 |