NPI | 1104165737 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 7981) |
Enumeration Date | 2013-02-01 |
Last Update Date | 2015-10-26 |