NPI | 1356396949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00700300) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT010623L) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2009-10-22 |