NPI | 1205525326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014714) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02174700) |
Enumeration Date | 2023-05-04 |
Last Update Date | 2023-06-22 |