| NPI | 1881620136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: OH PT004472) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: PA PT013103L) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2009-02-03 |