NPI | 1891705620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 06695) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: LA 06695) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2022-07-21 |