| NPI | 1437946969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA011273) |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-04-22 |