NPI | 1629557194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1303727) |
Enumeration Date | 2018-08-07 |
Last Update Date | 2022-06-06 |