| NPI | 1780911792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: TX 2119910) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: TX 677999) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2018-03-17 |