| NPI | 1841792207 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06006461A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2135750) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2022-06-27 |