NPI | 1710173513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16326) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1179450) |
Enumeration Date | 2007-09-14 |
Last Update Date | 2025-01-15 |