NPI | 1871128603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014416) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025697) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2021-01-18 |