| NPI | 1437328747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CA 34345) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: OH 012553) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OH PT.012553) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2021-12-30 |