| NPI | 1811155666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OK 27238) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY R1197) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2010-03-15 |