| NPI | 1316913767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35.033513) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: OH 35033513) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2011-07-14 |