NPI | 1447674379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 42551) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 42551) |
225100000X Physical Therapist (Licence: NV 2862) | |
Enumeration Date | 2014-02-12 |
Last Update Date | 2024-05-01 |