NPI | 1235905233 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT42364) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02227700) |
Enumeration Date | 2023-11-30 |
Last Update Date | 2024-09-27 |