NPI | 1649006883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH PTA013736) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MI 5502008435) |
Enumeration Date | 2024-09-13 |
Last Update Date | 2024-09-13 |