| NPI | 1467009746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06002840A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160003862) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |