NPI | 1518644426 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 13198) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 16205-24) |
Enumeration Date | 2023-07-03 |
Last Update Date | 2024-11-21 |