NPI | 1710629365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214945) |
Enumeration Date | 2022-04-12 |
Last Update Date | 2025-03-21 |