| NPI | 1932350956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA18758) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 66 006069) |
| 225200000X Physical Therapy Assistant (Licence: VA 2306602111) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |