NPI | 1013564921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT03769) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044743) |
Enumeration Date | 2019-08-26 |
Last Update Date | 2023-11-29 |