NPI | 1699382515 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 299190) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305213694) |
Enumeration Date | 2020-09-24 |
Last Update Date | 2022-12-08 |