NPI | 1588342299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16053) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014723) |
225100000X Physical Therapist (Licence: PA PTO031333) | |
Enumeration Date | 2023-07-11 |
Last Update Date | 2024-10-16 |