NPI | 1780235093 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.029254) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14854-24) |
Enumeration Date | 2019-09-27 |
Last Update Date | 2025-07-30 |