NPI | 1407673635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 304458) |
Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CA 304458) |
Enumeration Date | 2024-09-19 |
Last Update Date | 2024-09-19 |