NPI | 1598391492 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: AK 183475) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 4004) |
Enumeration Date | 2020-03-23 |
Last Update Date | 2024-05-07 |