NPI | 1336296763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA0696300) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA06963) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2010-04-30 |