NPI | 1194983353 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031324) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 031324) |
2251X0800X Physical Therapist, Orthopedic (Licence: NY 031324) | |
Enumeration Date | 2008-05-23 |
Last Update Date | 2018-06-26 |