NPI | 1861817801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 13484) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012203) |
225100000X Physical Therapist (Licence: TX 1254338) | |
225100000X Physical Therapist (Licence: MD 24972) | |
225100000X Physical Therapist (Licence: SC 7282) | |
225100000X Physical Therapist (Licence: NC P13484) | |
Enumeration Date | 2014-02-27 |
Last Update Date | 2022-01-17 |