NPI | 1750063350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0020427) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 304886) |
Enumeration Date | 2023-08-02 |
Last Update Date | 2025-04-16 |