| NPI | 1356893051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN CP032352A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA.011065) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2025-10-28 |