NPI | 1902066103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 303280-1) |
Enumeration Date | 2008-06-11 |
Last Update Date | 2019-05-31 |