NPI | 1932231594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 018882) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17758) |
225100000X Physical Therapist (Licence: NJ 40QA01232200) | |
Enumeration Date | 2007-03-09 |
Last Update Date | 2007-10-08 |