NPI | 1487490561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH11988) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: TN 15739) |
Enumeration Date | 2024-07-08 |
Last Update Date | 2024-12-02 |