NPI | 1659626042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: NY 62 034964) |
Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: RI PT02305) |
Enumeration Date | 2012-07-21 |
Last Update Date | 2012-07-21 |