NPI | 1952855785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AR 4234) |
Enumeration Date | 2016-08-10 |
Last Update Date | 2024-09-16 |