| NPI | 1922428168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: IN 05015497A) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: OH PT.012043) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2026-07-08 |