NPI | 1700486362 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 046366-01) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046366) |
Enumeration Date | 2020-10-31 |
Last Update Date | 2021-05-19 |