NPI | 1952848483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P23387) |
Additional Taxonomies | 225100000X Physical Therapist |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2017-01-23 |
Last Update Date | 2024-08-05 |