NPI | 1770785834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NC 3728) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA10822) |
225700000X Massage Therapist (Licence: FL MA9393) | |
Enumeration Date | 2007-06-01 |
Last Update Date | 2018-03-17 |