NPI | 1720509177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 296470) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012614) |
Enumeration Date | 2017-07-06 |
Last Update Date | 2023-02-23 |