| NPI | 1356400592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 004171) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 004171) |
| 225100000X Physical Therapist (Licence: OH 010112) | |
| 2251E1200X Physical Therapist, Ergonomics (Licence: OH 010112) | |
| 2251G0304X Physical Therapist, Geriatrics (Licence: OH 010112) | |
| 2251N0400X Physical Therapist, Neurology (Licence: OH 010112) | |
| 2251S0007X Physical Therapist, Sports (Licence: KY 004171) | |
| 2251S0007X Physical Therapist, Sports (Licence: OH 010112) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OH 010112) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: KY 004171) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-05-20 |