NPI | 1700650207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1400726) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT41043) |
Enumeration Date | 2023-11-14 |
Last Update Date | 2024-09-26 |