| NPI | 1427680123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT018468) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: OH PT018468) |
| 2251S0007X Physical Therapist, Sports (Licence: OH PT018468) | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |