| NPI | 1154416659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.090651) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.090651) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301075956) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-05-02 |