| NPI | 1831385558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 769) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE007740) |
| 225200000X Physical Therapy Assistant (Licence: MO 2007016469) | |
| 225200000X Physical Therapy Assistant (Licence: IA 001234) | |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2009-05-28 |