NPI | 1396144168 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035016) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 292523) |
Enumeration Date | 2014-08-18 |
Last Update Date | 2020-12-22 |