NPI | 1710726393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004771) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OH CP035178T) |
Enumeration Date | 2024-05-22 |
Last Update Date | 2024-09-26 |