{{ formErrors }}

{{ c.getValidUsernameMessage() }}

{{ c.getRequiredFieldText(c.practitioner.password,'password') }}

{{ c.getRequiredFieldText(c.practitioner.firstName,'firstName') }}


{{ c.getRequiredFieldText(c.practitioner.lastName,'lastName') }}

{{ c.getValidNpiMessage() }}

{{ c.getRequiredFieldText(c.practitioner.practitionerTypeId,'practitionerTypeId') }}

{{ c.getRequiredFieldText(c.practitioner.clientId,'clientId') }}

Product Name Selected
{{product.productName}}


{{ c.getRequiredFieldText(c.practitioner.clientPractitionerTypeId,'clientPractitionerTypeId') }}

 Yes     No