NPI | 1982385852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29728) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD T17311) |
Enumeration Date | 2023-07-25 |
Last Update Date | 2023-11-15 |