NPI | 1487109294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16620) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025461) |
Enumeration Date | 2016-08-22 |
Last Update Date | 2024-09-24 |