| NPI | 1467584771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AZ 7096A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VT 0410000496) |
| 225200000X Physical Therapy Assistant (Licence: MA 8114) | |
| 225200000X Physical Therapy Assistant (Licence: WY PTA527) | |
| 225200000X Physical Therapy Assistant (Licence: MT 1944PTA) | |
| 225200000X Physical Therapy Assistant (Licence: ID PTA2099) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |