NPI | 1407415334 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14891) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 11514) |
Enumeration Date | 2019-06-13 |
Last Update Date | 2024-08-28 |