NPI | 1407320880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28369) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0004025) |
Enumeration Date | 2019-01-18 |
Last Update Date | 2024-12-30 |