NPI | 1770933269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 14315) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040203) |
Enumeration Date | 2016-06-15 |
Last Update Date | 2025-01-06 |