NPI | 1619593852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 4OQAO1927100) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 4OQAO1927100) |
Enumeration Date | 2020-06-23 |
Last Update Date | 2020-10-20 |