NPI | 1801525134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: KY 008695) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008695) |
Enumeration Date | 2022-06-10 |
Last Update Date | 2023-02-02 |