NPI | 1720247513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 5806-24) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WI 5806-024) |
Enumeration Date | 2008-06-05 |
Last Update Date | 2025-04-22 |