NPI | 1508286022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: OH PTA.08838) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: OH AT.002711) |
Enumeration Date | 2014-04-23 |
Last Update Date | 2014-04-23 |