NPI | 1518213404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501011255) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2012-07-28 |
Last Update Date | 2021-11-10 |