NPI | 1215050554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00997700) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA pt011774l) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2024-09-11 |