NPI | 1790876449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 26714) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT293314) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2022-07-21 |