NPI | 1538632351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 31878) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: AZ 31878) |
225100000X Physical Therapist (Licence: HI PT-4719) | |
2251X0800X Physical Therapist, Orthopedic (Licence: CA 295551) | |
Enumeration Date | 2019-01-03 |
Last Update Date | 2024-08-30 |