NPI | 1831508662 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: RI PT02703) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21164) |
225100000X Physical Therapist (Licence: VA 2305208771) | |
Enumeration Date | 2014-08-06 |
Last Update Date | 2014-08-06 |