NPI | 1164810800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH 08780) |
Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: OH 08780) |
Enumeration Date | 2015-01-05 |
Last Update Date | 2023-06-14 |