NPI | 1457485336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 020022) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 20022-1) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2020-01-08 |