| NPI | 1437527702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT016578) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO 0013620) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2016-08-18 |