NPI | 1891489951 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: PTA01013) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: MT01287) |
Enumeration Date | 2023-06-02 |
Last Update Date | 2023-06-02 |