| NPI | 1821233008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: DE J2-0000238) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE007800) |
| 225200000X Physical Therapy Assistant (Licence: CA AT 8374) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |