NPI | 1609558246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT43013) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22492) |
Enumeration Date | 2023-08-03 |
Last Update Date | 2025-04-22 |