NPI | 1831624758 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003723) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020672) |
Enumeration Date | 2017-04-28 |
Last Update Date | 2017-05-12 |