| NPI | 1750795571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 06609) |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: OH 06609) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: OH 06609) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: OH 06609) | |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2014-06-19 |