NPI | 1750950754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047355) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 4813) |
Enumeration Date | 2021-06-23 |
Last Update Date | 2021-07-06 |