| NPI | 1013998186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A7684) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: OK 6909) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IL 036162106) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-03-04 |