NPI | 1447656681 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: VA 2306603564) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TX 2099787) |
Enumeration Date | 2014-11-17 |
Last Update Date | 2014-11-17 |