NPI | 1558764365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 0818) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: ND 0818) |
Enumeration Date | 2014-10-07 |
Last Update Date | 2022-04-06 |