NPI | 1487254827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216217) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT298478) |
Enumeration Date | 2020-10-26 |
Last Update Date | 2024-03-20 |