NPI | 1609689058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65731) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 20380) |
Enumeration Date | 2025-01-29 |
Last Update Date | 2025-06-18 |