NPI | 1427294875 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24718) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030964-1) |
225100000X Physical Therapist (Licence: CT 8524) | |
Enumeration Date | 2009-01-06 |
Last Update Date | 2024-02-29 |