| NPI | 1447027529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD CP046707A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MS 7666) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2025-07-17 |