NPI | 1568673275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 33364) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA36669) |
2471C3402X Radiologic Technologist, Radiography (Licence: FL BMO83271) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2025-03-20 |