NPI | 1730450289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23923) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501015212) |
Enumeration Date | 2012-01-14 |
Last Update Date | 2023-06-20 |