NPI | 1760163828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 4779) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 301681) |
Enumeration Date | 2023-07-31 |
Last Update Date | 2023-07-31 |