NPI | 1396997029 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11459) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0068954) |
Enumeration Date | 2008-10-13 |
Last Update Date | 2023-12-28 |