NPI | 1447337969 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT016038) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OH PTA 05972) |
225100000X Physical Therapist (Licence: WV 003396) | |
225200000X Physical Therapy Assistant (Licence: KY PTA A01986) | |
Enumeration Date | 2006-11-01 |
Last Update Date | 2020-07-13 |