| NPI | 1003922873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: KY 43090) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2020041932) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2024-03-29 |