| NPI | 1831479583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P1 60031717) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 8571) |
| 225200000X Physical Therapy Assistant (Licence: IL 160.003891) | |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |