| NPI | 1033170931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 144674) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: AL 15793) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 17079) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 104975) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: WV 18862) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NY 144674) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: AL 15793) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: OK 17079) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MO 104975) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: WV 18862) | |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-05-19 |