NPI | 1992823918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501008069) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11565) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2023-01-10 |