NPI | 1861255747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-033620) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032003) |
Enumeration Date | 2024-02-02 |
Last Update Date | 2024-08-28 |