NPI | 1942743422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH8918) |
2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: AL PTH8918) | |
Enumeration Date | 2016-12-01 |
Last Update Date | 2024-09-03 |