NPI | 1598996654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MN 9270) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18757) |
225100000X Physical Therapist (Licence: MT 11380) | |
Enumeration Date | 2009-08-06 |
Last Update Date | 2023-08-02 |