NPI | 1578876108 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA33745) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH11673) |
Enumeration Date | 2010-07-25 |
Last Update Date | 2024-10-18 |