NPI | 1558630087 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WA P1 60039334) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 7706) |
Enumeration Date | 2011-12-29 |
Last Update Date | 2011-12-29 |