NPI | 1497532162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2179123) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: KS 14-04143) |
Enumeration Date | 2023-09-14 |
Last Update Date | 2024-12-28 |