NPI | 1720842008 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 247200000X Technician, Other |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2105301) |
Enumeration Date | 2024-02-07 |
Last Update Date | 2025-05-29 |