NPI | 1760669238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22924) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012332) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2023-01-24 |