NPI | 1437603016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 10354) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MN 10354) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2025-08-14 |