| NPI | 1245214121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT 004515) |
| Additional Taxonomies | 2251H1200X Physical Therapist, Hand (Licence: OH 9611000450-HTCC) |
| Enumeration Date | 2005-12-03 |
| Last Update Date | 2012-02-24 |