NPI | 1972224418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 237725) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT61345509) |
Enumeration Date | 2022-09-02 |
Last Update Date | 2025-06-18 |