NPI | 1750687901 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 9420) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 7329920) |
Enumeration Date | 2011-02-07 |
Last Update Date | 2015-03-19 |