| NPI | 1689985764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06003741A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2076106) |
| 225200000X Physical Therapy Assistant (Licence: TN 4793) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |