NPI | 1497448187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MI 5501302468) |
Enumeration Date | 2023-05-30 |
Last Update Date | 2025-04-28 |