| NPI | 1437732914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 30928) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL pta30928) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |