| NPI | 1730427758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH 07613) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2086810) |
| 225200000X Physical Therapy Assistant (Licence: CA 9964) | |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |