| NPI | 1023889532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH 007565) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: 007565) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-12 |