NPI | 1538444849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01461600) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031921) |
Enumeration Date | 2011-10-18 |
Last Update Date | 2023-06-07 |