NPI | 1730226747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 2398) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT16888) |
225100000X Physical Therapist (Licence: FL PT 16888) | |
Enumeration Date | 2007-01-31 |
Last Update Date | 2022-05-12 |