NPI | 1669035150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 18601) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT6636) |
Enumeration Date | 2019-04-19 |
Last Update Date | 2019-07-26 |