NPI | 1457091282 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO CP010362T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT4804) |
225100000X Physical Therapist (Licence: NC P-CP011162T) | |
Enumeration Date | 2022-03-30 |
Last Update Date | 2022-07-25 |