NPI | 1598769085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6597) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 020670) |
225100000X Physical Therapist (Licence: NC 13551) | |
Enumeration Date | 2005-06-13 |
Last Update Date | 2024-10-02 |