NPI | 1780974543 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032265) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 007157) |
Enumeration Date | 2011-04-13 |
Last Update Date | 2023-02-10 |