| NPI | 1275896524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 013728) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT013728) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2024-12-05 |