NPI | 1629317698 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005113) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IA 005113) |
Enumeration Date | 2013-02-11 |
Last Update Date | 2025-02-26 |