NPI | 1861894743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011738) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29656) |
Enumeration Date | 2014-09-22 |
Last Update Date | 2022-07-21 |