NPI | 1538550157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT024259) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01587100) |
Enumeration Date | 2015-02-18 |
Last Update Date | 2015-02-18 |