| NPI | 1518992510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35086151) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: UT 6208042-1205) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-07-27 |