NPI | 1467066654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 016008) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 298170) |
Enumeration Date | 2020-09-03 |
Last Update Date | 2023-05-15 |