| NPI | 1326034299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: OH PT004253) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: OH Pt 004253) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT 004253) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT004253) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2012-12-03 |