NPI | 1568548659 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 004780-1) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: NY X003779-1) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2017-02-22 |