NPI | 1174991293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT015092) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01570300) |
Enumeration Date | 2015-09-05 |
Last Update Date | 2021-04-21 |