NPI | 1780041459 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1333267) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60623867) |
Enumeration Date | 2016-01-26 |
Last Update Date | 2023-08-22 |