NPI | 1952451601 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 013221) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 013221-1) |
Enumeration Date | 2007-01-12 |
Last Update Date | 2020-06-24 |