NPI | 1588127484 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1312954) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 296170) |
Enumeration Date | 2019-04-09 |
Last Update Date | 2022-04-19 |