| NPI | 1003974551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AL 13435) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 13435) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-06-22 |