NPI | 1902441439 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WY PT1932) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044522) |
Enumeration Date | 2019-11-07 |
Last Update Date | 2020-09-28 |