NPI | 1568963619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: CO 14274) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 9560) |
Enumeration Date | 2018-02-23 |
Last Update Date | 2018-02-23 |