NPI | 1225281041 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 026050) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 026050) |
Enumeration Date | 2008-10-23 |
Last Update Date | 2017-04-17 |