{{ 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