NPI | 1700433877 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21108) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: RI PT03217) |
Enumeration Date | 2019-08-22 |
Last Update Date | 2022-04-26 |