| NPI | 1952017329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NE 1983) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IL 160009531) |
| 225200000X Physical Therapy Assistant (Licence: OR 10058) | |
| 225200000X Physical Therapy Assistant (Licence: SD CP017868A) | |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-02-01 |