| NPI | 1144917345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NV A-1452) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 51576) |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-04-19 |