| NPI | 1013259357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: CA A173881) |
| Additional Taxonomies | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: NY 290432) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-11-04 |