NPI | 1740841725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06269) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1308610) |
225100000X Physical Therapist (Licence: MO 2019029583) | |
Enumeration Date | 2019-06-21 |
Last Update Date | 2019-08-15 |