NPI | 1700846748 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00485800) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT009524L) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2015-08-11 |