NPI | 1659319440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 034111) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 8813) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2016-09-28 |