NPI | 1952875031 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1309501) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 15306) |
Enumeration Date | 2019-01-11 |
Last Update Date | 2023-09-29 |