| NPI | 1538109426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35062750) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: OH PT 03793) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-12-06 |