NPI | 1427601053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 12192586-2401) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60966231) |
Enumeration Date | 2019-07-23 |
Last Update Date | 2021-05-25 |