NPI | 1710109905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: OH 35089913) |
Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: OH AO56037246071615) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2011-09-08 |