NPI | 1164446449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10961) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 012378) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2016-11-16 |