NPI | 1588156970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20329) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019016461) |
225100000X Physical Therapist (Licence: KS 11-05958) | |
Enumeration Date | 2018-06-01 |
Last Update Date | 2021-04-05 |