NPI | 1730625971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32266) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501018072) |
Enumeration Date | 2017-01-11 |
Last Update Date | 2021-07-20 |