NPI | 1548562523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 39061) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002540) |
Enumeration Date | 2010-11-24 |
Last Update Date | 2021-11-30 |