| NPI | 1891519039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: AR pta867) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: pta867) |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-13 |