NPI | 1619715869 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014906) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 12439) |
Enumeration Date | 2024-07-19 |
Last Update Date | 2025-07-15 |