NPI | 1013105170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01317300) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008901A) |
225100000X Physical Therapist (Licence: MI 5501012700) | |
Enumeration Date | 2007-10-12 |
Last Update Date | 2012-06-28 |