NPI | 1912498395 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501012926) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501012916) |
Enumeration Date | 2018-05-22 |
Last Update Date | 2018-05-22 |