NPI | 1679946750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 038034-1) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024806) |
225100000X Physical Therapist (Licence: ZZ 0019900) | |
Enumeration Date | 2015-11-11 |
Last Update Date | 2015-11-11 |