| NPI | 1598096125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT017757) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OH 66.000066) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2025-01-06 |