NPI | 1538687587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029154) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 19117) |
225500000X Specialist/Technologist | |
Enumeration Date | 2017-08-30 |
Last Update Date | 2023-07-11 |