NPI | 1942792064 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251N0400X Physical Therapist, Neurology |
2251P0200X Physical Therapist, Pediatrics | |
Enumeration Date | 2018-06-04 |
Last Update Date | 2019-09-11 |