NPI | 1134511165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 25265) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: SC 3182) |
Enumeration Date | 2015-02-27 |
Last Update Date | 2015-02-27 |