NPI | 1669659124 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
Additional Taxonomies | 225200000X Physical Therapy Assistant |
Enumeration Date | 2008-01-28 |
Last Update Date | 2008-01-28 |