NPI | 1407114143 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA 60266820) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CA 9312) |
Enumeration Date | 2012-05-01 |
Last Update Date | 2012-06-14 |