NPI | 1831610534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: DE J1-0003770) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
Enumeration Date | 2017-07-03 |
Last Update Date | 2018-12-07 |