NPI | 1285677344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01115100) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 25903) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2014-10-28 |