NPI | 1477337038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 304730) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 304730) |
Enumeration Date | 2023-08-23 |
Last Update Date | 2023-11-08 |