NPI | 1548784655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23340) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT4886) |
Enumeration Date | 2017-07-31 |
Last Update Date | 2018-12-18 |