NPI | 1992200091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10370) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 038348) |
Enumeration Date | 2018-03-29 |
Last Update Date | 2018-03-29 |