NPI | 1922174184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15754) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 3003) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2023-04-26 |