Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA00724200 | NJ |
NPI | 1013181742 |
---|---|
Provider Name | Rommel L Santos |
First Address | Cherry Hill, NJ 08034-1513 |
Second Address | Cherry Hill, NJ 08034-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 14/04/2008 |