| NPI | 1346739737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2015517) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD CP022392A) |
| 225200000X Physical Therapy Assistant (Licence: NH 1445) | |
| 225200000X Physical Therapy Assistant (Licence: VT 041.0134009) | |
| 225200000X Physical Therapy Assistant (Licence: VA CP026481A) | |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-07-12 |