| NPI | 1801826953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081P0004X Physical Medicine & Rehabilitation Spinal Cord Injury Medicine (Licence: OH 34-006814) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: OH 34-006814) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2014-09-26 |