NPI | 1144945114 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WV 002419) |
Additional Taxonomies | 251E00000X Home Health (Licence: WV 002419) |
Enumeration Date | 2022-10-11 |
Last Update Date | 2023-11-29 |