| NPI | 1235332446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH SW725157) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 57009039) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2023-09-22 |