NPI | 1053137521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 054236) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 047881) |
Enumeration Date | 2024-11-29 |
Last Update Date | 2025-05-19 |