NPI | 1780184416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT294411) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 294411) |
Enumeration Date | 2018-02-19 |
Last Update Date | 2022-03-16 |