NPI | 1619278892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P13698) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033230-1) |
Enumeration Date | 2010-11-04 |
Last Update Date | 2015-09-14 |