NPI | 1184722951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00982400) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0242161) |
Enumeration Date | 2006-09-20 |
Last Update Date | 2015-06-19 |