NPI | 1770753238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 023875) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 023875) |
Enumeration Date | 2008-03-11 |
Last Update Date | 2020-02-26 |