NPI | 1457157307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501303744) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: IN 0515950A) |
Enumeration Date | 2025-02-21 |
Last Update Date | 2025-09-06 |