| NPI | 1487984852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE007399) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH 06358) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2010-01-07 |