NPI | 1972500544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 16417) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ QA08473) |
Enumeration Date | 2005-06-28 |
Last Update Date | 2014-02-12 |