NPI | 1801291562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 3883) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12913 - 24) |
225100000X Physical Therapist (Licence: TX 1212447) | |
225100000X Physical Therapist (Licence: CA 291303) | |
Enumeration Date | 2014-10-23 |
Last Update Date | 2018-04-24 |