NPI | 1730498973 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 6356) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8814) |
Enumeration Date | 2010-10-06 |
Last Update Date | 2023-04-19 |