NPI | 1609103076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P14177) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8526) |
Enumeration Date | 2009-11-05 |
Last Update Date | 2022-06-17 |