NPI | 1548320377 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 22339) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028862) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2010-10-21 |