NPI | 1740575893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 015213) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014130) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2015-06-29 |