| NPI | 1033132683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35085103) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MN 42068) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-12-07 |