NPI | 1932888443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT03992) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 13160) |
Enumeration Date | 2023-07-12 |
Last Update Date | 2025-06-03 |