NPI | 1831631324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040984) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 040984) |
Enumeration Date | 2016-11-15 |
Last Update Date | 2018-03-14 |