NPI | 1679074322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05012807A) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1303057) |
Enumeration Date | 2018-02-27 |
Last Update Date | 2023-11-15 |