NPI | 1841578929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021280) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24017) |
225100000X Physical Therapist (Licence: DE J1-0002725) | |
Enumeration Date | 2011-07-24 |
Last Update Date | 2019-12-13 |