| NPI | 1831583574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06004967A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160.005886) |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |