NPI | 1346296860 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01019800) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ 40QA01049800) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2008-09-12 |