NPI | 1952994931 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 299866) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 299866) |
Enumeration Date | 2021-02-19 |
Last Update Date | 2023-06-23 |