NPI | 1538610902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27239) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11708) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2019-05-17 |