NPI | 1285025304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: GA PTA000935) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA11413) |
Enumeration Date | 2015-02-11 |
Last Update Date | 2015-02-11 |