NPI | 1285862078 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: IA 00519) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: IA 03303) |
Enumeration Date | 2009-06-30 |
Last Update Date | 2009-06-30 |