| NPI | 1073526000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35-068633) |
| Additional Taxonomies | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: OH 35-068633) |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: KY 33648) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |