| NPI | 1013448042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 6730) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL OS17644) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2026-04-14 |