NPI | 1275831778 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003839) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033145) |
225100000X Physical Therapist (Licence: NJ 40QA01436200) | |
Enumeration Date | 2011-03-08 |
Last Update Date | 2018-04-30 |