NPI | 1881357861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 1881357861) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT029965) |
Enumeration Date | 2021-10-18 |
Last Update Date | 2023-11-30 |