| NPI | 1548314008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA Pl 60033988) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2009-04-28 |