| NPI | 1346479144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD A3034) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: DE J2-0000650) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |