NPI | 1992137608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1234493) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3268) |
Enumeration Date | 2013-08-05 |
Last Update Date | 2020-10-14 |