NPI | 1487343653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 13397961-2401) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: UT 13397961-2401) |
Enumeration Date | 2023-05-03 |
Last Update Date | 2023-06-14 |