| NPI | 1306835145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35134992) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NV 16186) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MA05971300) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: PA MD032799E) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: UT 7277536-1205) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-05-19 |