NPI | 1720638513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007827) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KY TP2019108) |
Enumeration Date | 2019-09-13 |
Last Update Date | 2021-12-03 |