NPI | 1578118824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 034004) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63654) |
Enumeration Date | 2019-08-05 |
Last Update Date | 2024-12-31 |