NPI | 1568518769 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 016311-1) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NY 016311-1) |
Enumeration Date | 2007-01-28 |
Last Update Date | 2012-06-21 |