NPI | 1518439470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211630) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63063) |
Enumeration Date | 2018-12-17 |
Last Update Date | 2018-12-17 |