NPI | 1689454472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: WA PT60354731) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 303454) |
Enumeration Date | 2023-09-29 |
Last Update Date | 2023-09-29 |