NPI | 1770255655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 047745-01) |
Enumeration Date | 2021-09-29 |
Last Update Date | 2021-09-29 |