NPI | 1659952661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 167350) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0014269) |
225100000X Physical Therapist (Licence: FL PT35868) | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2021-04-20 |