| NPI | 1477718195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06003444A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1356) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |