NPI | 1194899013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00749200) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA00749200) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2023-03-24 |