| NPI | 1538353339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR 2073) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 8413) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |