NPI | 1598785693 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 034665-1) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ PT 40QA01197700) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2020-02-25 |