| NPI | 1922754191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160.006758) |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2022-02-26 |
| Last Update Date | 2022-02-26 |