NPI | 1649944059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP030320T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02026700) |
Enumeration Date | 2021-08-09 |
Last Update Date | 2024-09-22 |