| NPI | 1932120094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AZ 73541) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35.075381) |
| 208100000X Physical Medicine & Rehabilitation (Licence: KY 34662) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OH 35-075381) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: KY 34662) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2024-09-09 |