NPI | 1952815235 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT013049) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
2251X0800X Physical Therapist, Orthopedic (Licence: GA 013049) | |
Enumeration Date | 2017-11-26 |
Last Update Date | 2022-01-03 |