NPI | 1932453321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1224336) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1224336) |
Enumeration Date | 2012-11-06 |
Last Update Date | 2022-05-25 |