| NPI | 1114968666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WV 2401) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036111718) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101017513) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 6154) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: HI DOS-750) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: IN 02003421A) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-02-08 |