NPI | 1245484658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA21022) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 21022) |
225200000X Physical Therapy Assistant (Licence: CA 6693) | |
Enumeration Date | 2008-11-12 |
Last Update Date | 2020-01-13 |