NPI | 1881159887 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA PT027398) |
Enumeration Date | 2019-02-04 |
Last Update Date | 2021-05-24 |