NPI | 1578109153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC CP022892T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: ME 5520) |
Enumeration Date | 2019-11-19 |
Last Update Date | 2025-07-23 |