| NPI | 1497973945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IL 160004561) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 005467) |
| 225200000X Physical Therapy Assistant (Licence: SC 2037) | |
| 225200000X Physical Therapy Assistant (Licence: NC a3382) | |
| 225200000X Physical Therapy Assistant (Licence: VA 2306602097) | |
| 225200000X Physical Therapy Assistant (Licence: CT 000918) | |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2025-09-11 |