| NPI | 1932531431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: SC 2482) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IN 06004633A) |
| 225200000X Physical Therapy Assistant (Licence: VA 2306603678) | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2013-08-07 |