NPI | 1649924036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT7787) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501301917) |
225100000X Physical Therapist (Licence: AL PTH10869) | |
Enumeration Date | 2022-02-05 |
Last Update Date | 2024-08-15 |