| NPI | 1659628253 |
|---|---|
| Professional Name | ROBERT PAUL DERRICKSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: PA 000560e) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |