| NPI | 1619392891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IL 160006681) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IN 06004755A) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-02-25 |