NPI | 1114563269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01904600) |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2019-11-25 |
Last Update Date | 2023-09-21 |