NPI | 1962152876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 30011) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 14114) |
225100000X Physical Therapist | |
Enumeration Date | 2022-03-24 |
Last Update Date | 2024-07-04 |