NPI | 1477157659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214096) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2020-11-28 |
Last Update Date | 2021-04-28 |