NPI | 1861524837 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT011537L) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00535800) |
Enumeration Date | 2007-03-12 |
Last Update Date | 2007-07-08 |