NPI | 1811562473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0018730) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2021-05-25 |
Last Update Date | 2022-10-19 |