NPI | 1972116473 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC CP042332T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: OK 5932) |
225100000X Physical Therapist (Licence: GA PT014770) | |
Enumeration Date | 2020-08-25 |
Last Update Date | 2025-03-11 |