NPI | 1184221533 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 050475) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT028854) |
Enumeration Date | 2020-10-07 |
Last Update Date | 2023-05-31 |