| NPI | 1851507834 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA9044) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE000972L) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |