| NPI | 1720238207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P160449793) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC 3889) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2024-08-23 |