NPI | 1841746039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01681200) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27416) |
Enumeration Date | 2016-08-29 |
Last Update Date | 2020-08-05 |