NPI | 1255700332 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8869) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 082089) |
225100000X Physical Therapist (Licence: NJ 40QA01620200) | |
Enumeration Date | 2015-09-18 |
Last Update Date | 2018-12-17 |