NPI | 1861893273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01612800) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 130292014) |
Enumeration Date | 2014-09-05 |
Last Update Date | 2020-07-10 |