| NPI | 1043620040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CT 71185) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 25MB10358300) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101022077) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: NY 306868) | |
| 2081N0008X Physical Medicine & Rehabilitation, Neuromuscular Medicine (Licence: CT 71185) | |
| 208D00000X General Practice (Licence: MI 5101022077) | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2024-02-16 |