NPI | 1336262468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PA TE006691) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT000071A) |
Enumeration Date | 2007-04-06 |
Last Update Date | 2007-07-08 |