NPI | 1831846351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MD A5790) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 113258-01) |
225200000X Physical Therapy Assistant (Licence: TX 2174554) | |
225200000X Physical Therapy Assistant (Licence: NY 013631-01) | |
Enumeration Date | 2022-03-04 |
Last Update Date | 2025-01-07 |