NPI | 1811315955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 037490-1) |
225100000X Physical Therapist | |
2251H1200X Physical Therapist, Hand | |
2251X0800X Physical Therapist, Orthopedic | |
Enumeration Date | 2014-04-05 |
Last Update Date | 2019-02-02 |