| NPI | 1275801524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH PTA 7632) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 9681) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |