| NPI | 1447049267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 2164) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NM 2164) |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2026-01-11 |