| NPI | 1750478343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT006681) |
| Additional Taxonomies | 2251C2600X Physical Therapist Cardiopulmonary (Licence: OH PT 006681) |
| 2251E1200X Physical Therapist Ergonomics (Licence: OH PT 006681) | |
| 2251S0007X Physical Therapist Sports (Licence: OH PT 006681) | |
| 2251X0800X Physical Therapist Orthopedic (Licence: OH PT 006681) | |
| 2251G0304X Physical Therapist Geriatrics (Licence: OH PT 006681) | |
| 2251H1300X Physical Therapist Human Factors (Licence: OH PT 006681) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2022-07-21 |