NPI | 1447626601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039268-1) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006693) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2015-08-11 |