| NPI | 1881020204 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IN 06004735A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA.09127) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2013-09-17 |