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Individual
JARED TAKESHI AIDA
Active
Individual
JARED TAKESHI AIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
123456-1205
UT
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
123456-1205
UT
Other
Enumeration date
06/09/2014
Last updated
08/24/2023
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