NPI | 1508533118 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA PTL26909) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT-5260) |
Enumeration Date | 2021-08-23 |
Last Update Date | 2023-11-20 |