| NPI | 1386351609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD A5640) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 51652) |
| 225200000X Physical Therapy Assistant (Licence: FL PTA32173) | |
| 225200000X Physical Therapy Assistant (Licence: NC CP014946A) | |
| 225200000X Physical Therapy Assistant (Licence: GA CP015771A) | |
| 225200000X Physical Therapy Assistant (Licence: NM PT-2023-2071) | |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-12-13 |