NPI | 1932120094 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY 34662) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35-075381) |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: KY 34662) | |
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OH 35.075381) | |
Enumeration Date | 2006-07-22 |
Last Update Date | 2024-04-01 |