NPI | 1821067596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35-091385) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX M1913) |
Enumeration Date | 2006-03-15 |
Last Update Date | 2011-06-23 |