| NPI | 1134555147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VT 041.0134004PROV) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN CP010737A) |
| 225200000X Physical Therapy Assistant (Licence: VA CP018387A) | |
| 225200000X Physical Therapy Assistant (Licence: GA PTA003128) | |
| 225200000X Physical Therapy Assistant (Licence: SC 4867) | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2024-06-01 |