NPI | 1437695608 |
---|---|
Other Name | JUAN GOMEZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT2995) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT039669) |
Enumeration Date | 2017-01-12 |
Last Update Date | 2017-01-12 |