| NPI | 1700637659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand |
| 225200000X Physical Therapy Assistant | |
| 251S00000X Community/Behavioral Health | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-06-25 |