NPI | 1083907018 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NJ 40QB00284500) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TEI002959) |
225200000X Physical Therapy Assistant (Licence: DE J2-0000867) | |
Enumeration Date | 2011-05-24 |
Last Update Date | 2012-10-23 |