NPI | 1659833127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: LA A10245R) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TEI005182) |
Enumeration Date | 2019-04-03 |
Last Update Date | 2019-04-09 |