NPI | 1811414865 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 4950) |
Additional Taxonomies | 225200000X Physical Therapy Assistant |
Enumeration Date | 2017-08-29 |
Last Update Date | 2022-07-21 |