NPI | 1003208182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01589100) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2015-02-25 |
Last Update Date | 2020-06-23 |