NPI | 1851990279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT301056) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305213958) |
Enumeration Date | 2020-10-19 |
Last Update Date | 2021-10-01 |