NPI | 1609271469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA25288) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA67502) |
Enumeration Date | 2014-10-22 |
Last Update Date | 2014-10-22 |