NPI | 1801023544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019957) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT109957) |
Enumeration Date | 2009-06-21 |
Last Update Date | 2021-03-15 |