NPI | 1245566280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031277) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031277-1) |
2251X0800X Physical Therapist, Orthopedic (Licence: NY 031277) | |
Enumeration Date | 2009-10-27 |
Last Update Date | 2020-07-08 |