NPI | 1710559026 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029818) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA TPT023454) |
Enumeration Date | 2021-07-15 |
Last Update Date | 2021-09-08 |