NPI | 1336598705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO PTA.0013719) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MA 9182) |
Enumeration Date | 2016-06-07 |
Last Update Date | 2016-06-07 |