NPI | 1225697741 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040900) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 300352) |
Enumeration Date | 2019-06-08 |
Last Update Date | 2022-09-29 |