NPI | 1770745465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT027777) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 5753) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2024-05-21 |