NPI | 1982100269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT294362) |
Enumeration Date | 2018-04-04 |
Last Update Date | 2019-09-23 |