NPI | 1811360456 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003967) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 078483) |
Enumeration Date | 2015-11-04 |
Last Update Date | 2018-09-25 |